What is an allergy?
An allergy is an exaggerated response of the immune system to substances that are usually harmless, such as pollen, dust mites, certain foods, medications, insect stings, or pet dander. Allergic reactions can affect the skin, nose, lungs, eyes, or digestive system.
What is urticaria?
Urticaria, commonly known as hives, is a skin condition characterized by itchy, raised, red or skin-colored swellings (wheals) that appear suddenly and usually disappear within hours.
What is chronic urticaria?
Chronic urticaria is defined as recurrent hives occurring on most days of the week for more than six weeks. The wheals may come and go but continue to recur over a prolonged period.
Is chronic urticaria always caused by an allergy?
No. Contrary to popular belief, most cases of chronic urticaria are not due to a specific allergy. In many patients, no identifiable trigger is found. Autoimmune mechanisms are believed to play a role in a significant number of cases.
What are the common symptoms of chronic urticaria?
Symptoms include: Itchy wheals or hives, red or skin-colored raised patches, burning or stinging sensation, swellings that change location. Symptoms that worsen at night in some individuals
What is angioedema?
Angioedema is a deeper swelling of the skin and tissues, often affecting the lips, eyelids, tongue, face, hands, or feet. It may occur along with urticaria and can occasionally be serious if it affects the airway.
What factors can trigger or worsen chronic urticaria?
Potential triggers include: Infections, stress and anxiety, heat or cold exposure, pressure on the skin, certain painkillers (especially NSAIDs), alcohol, hormonal changes Physical exertion
Can food allergies cause chronic urticaria?
Food allergies can cause acute urticaria, but they are an uncommon cause of chronic urticaria. Unnecessary dietary restrictions should be avoided unless a clear relationship is established.
How is chronic urticaria diagnosed?
Diagnosis is mainly based on medical history and physical examination. Extensive allergy testing is usually not necessary unless suggested by the patient’s history. Investigations may be done to rule out associated conditions when indicated.
Can stress cause hives?
Stress may not directly cause chronic urticaria, but it can significantly aggravate symptoms and increase the frequency and severity of outbreaks in susceptible individuals.
Are any blood tests required?
Basic investigations may include: Complete blood count, ESR or CRP, thyroid function tests in selected cases, and additional tests based on symptoms and clinical findings
What is the standard treatment for chronic urticaria?
Second-generation non-sedating antihistamines are the first-line treatment. These medications help control itching and wheals and are generally safe for long-term use under medical supervision.
What if antihistamines do not work?
When symptoms remain uncontrolled, doctors may increase the antihistamine dose or consider advanced therapies such as Omalizumab. In selected resistant cases, other immunomodulatory treatments may be considered.
Are steroids useful in chronic urticaria?
Short courses of corticosteroids may occasionally be used for severe flare-ups. However, long-term steroid use is generally avoided because of significant side effects such as diabetes, hypertension, osteoporosis, cataracts, and infections.
Author: Dr Jay Deshmukh
Dr Jay Deshmukh is Chief Physician and Director, Sunflower Hospital, Nagpur Honorary Physician to Honorable Governor of Maharashtra and PondicherryCentral. Dr Jay Deshmukh is an M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD From Internal Medicine – Bombay and New Delhi.
